1. What is hypogonadism? Testosterone is produced by Leydig cells in the testes, in response to luteinizing hormone produced by the pituitary gland. Decreased production of testosterone by testes in men is characterized as hypogonadism, which is classified as primary, secondary, or mixed. Primary hypogonadism is failure of the testes to produce sufficient testosterone, whereas secondary hypogonadism is caused by decreased production of luteinizing hormone.
2. What are the signs and symptoms of low testosterone? There are many physical and mental signs of low testosterone, many of which include: Low energy, decreased sense of vitality or sense of well-being, diminished muscle mass and strength, depressed mood, decrease in stamina, increased body fat, decrease in mental clarity and focus, low sex drive, decreased or absent morning erections, diminished work or physical performance, etc.
3. Is Testosterone Replacement Therapy right for everyone? Not every patient with low serum testosterone levels is a candidate for therapy. A detailed history and physical is required to evaluate for any absolute/relative contraindications of therapy which include but not limited to breast cancer, polycythemia (hematocrit >54%), prostate cancer, PSA > 4ng per mL, etc.
4. How will Testosterone Replacement Therapy help me? Many of our patients begin to start experiencing positive results within the first 6 weeks of therapy, specifically with regards to improvements in mental clarity, focus, mood and libido. Improvements in sexual/erectile function soon follow within the first 12 weeks of therapy.
5. What is considered a normal testosterone level? This is an excellent question as it is dependent upon the laboratory where your sample has been tested as each lab has different methodologies of analysis and hence specific parameters. Most experts agree that the goal serum testosterone level “should be in the midnormal range (i.e., 400-700 ng per dL); As literature states, testosterone levels begin to decline around 30-40 years of age and they go onto saying that by 80 years of age, more than 50% of men will have testosterone levels in the low range (using a reference range defined by nonobese, healthy men YOUNGER than 40 years).
6. Are there any risks associated with Testosterone Replacement Therapy? Like every medication, there can be side effects with taking testosterone. Some possible risks include rising prostate-specific antigen levels, worsening lower urinary tract symptoms, polycythemia, and increased risk of venous thromboembolism.
7. What is the role of Human Chorionic Gonadotropin (HcG) with Testosterone Replacement Therapy? HcG when used in conjunction with Testosterone Replacement Therapy promotes weight loss but also assists in maintaining testicular volume by continuing to promote the natural testosterone production of the testes.
8. How should male patients be monitored while being on Testosterone Replacement Therapy? Patients receiving testosterone therapy should be monitored to ensure testosterone levels rise appropriately, clinical improvement occurs, and no complications develop. Throughout the therapy patients may also need to routinely check PSA, Estradiol, CBC and Iron levels.
9. What are the different types of Testosterone Replacement Therapy? WellingtonMD offers (2) forms of therapy to help manage symptoms of Low Testosterone.
(1) TRT also known as Testosterone Replacement Therapy consist of injections of testosterone.
(2) THRT also known as Total Hormone Replacement Therapy includes testosterone, HcG, and Anastrozole which if indicated is the preferred therapy where all hormone levels are maintained at an balanced level.
10. What is the cost of Testosterone Replacement Therapy? The expected cost will differ from one center to another, however patients of WellingtonMD can expect to see the average cost of treatment to be approximately $50 a week.
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